Individual provider Active NPI

Bryan David Douglas, D.C.

  • Chiropractor
  • Vero Beach, FL
National Provider Identifier
1013243245
Registry record updated Jun 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH 9788 Issued in FL
Practice address
778 S US 1
Vero Beach, FL 32962-4701
Phone
(772) 567-4661
Fax
(772) 567-4641
NPI assigned
Oct 22, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH 9788 FL Primary

Addresses

Primary practice location

778 S US 1
Vero Beach, FL 32962-4701

Mailing address

1550 SE Wilshire PL Apt 103
Stuart, FL 34994-5780
Phone (772) 834-9467

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200218001510 FL Practitioner - Chiropractic 7810324696 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
New York Chiropractic College, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ocean Chiropractic and Health Center IncGroup PAC ID 8527012020, 4 clinicians

Practice addresses (Care Compare)

1800 43Rd Ave
Suite a
Vero Beach, FL 32960-0531
Phone (772) 460-9000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH 9788FLMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Ocean Chiropractic & Health Center, Inc. Chiropractor CurrentSince Dec 1, 2019 Accepting new patients
BDDC Consulting LLC Chiropractor Past Accepting new patients

Locations

805 Virginia Ave
Ste 11
Fort Pierce, FL 34982
Phone (772) 460-9000

805 Virginia Ave
Ste 10
Fort Pierce, FL 34982
Phone (561) 972-4645

725 Commerce Center Dr
Ste D
Sebastian, FL 32958

1800 43rd Ave
Ste A
Vero Beach, FL 32960
Phone (772) 258-4660

Networks

  • AL HMO
  • devoted network organization-d5084670-562f-408b-b100-22a1a4ef4d82
  • FL HMO D-SNP
  • FL PPO
  • FL HMO
  • devoted network organization-14bfd35d-d818-4696-813b-340339e464ef
  • FL HMO C-SNP
  • devoted network organization-25ba88d3-d0a6-4213-84f1-eef6f2b59f68
  • AL HMO D-SNP

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1256169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560384000000",
    "number": "1013243245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1550 SE WILSHIRE PL APT 103",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349945780",
            "telephone_number": "772-834-9467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "778 S US 1",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329624701",
            "telephone_number": "772-567-4661",
            "fax_number": "772-567-4641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGLAS",
        "first_name": "BRYAN",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-10-22",
        "last_updated": "2019-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH 9788",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vero Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.